Wednesday, August 22, 2012

Update on Proposed New WCA Descriptors (EBR)

We've been passed the latest version of the Evidence Based Review WCA descriptors for people to comment on and scrutinise. This version has to be finalised by the end of the week so there isn't much time. If you leave comments below I can direct the right people to read them but due to health issues I won't be able to do more than that. There's also a slightly different scoring system proposed, but for consultation purposes all you really need to know is that the N/A, Occasional, Frequent, Most boxes roughly correlate to points as follows, 0, 6, 9, 15

Health prevents me from going through this in the detail it requires but my initial impression is that it has lost much of the simplicity of the earlier draft and it appears to me that this is much closer to what a joint test for ESA and PIP would look like... However, testing an alternative version of a WCA can only be a good thing if the DWP are sensible enough to compare both proposals and cherry pick the best parts..

But please bear in mind - intense pain and lots of oramorph do not make for good cognitive functioning!

Movement
- within a work environment or travelling to work

1.Mobilising

Mobilising unaided by another
person with or without a walking stick, manual wheelchair or other aid
normally used, for long periods indoors and outdoors without stopping, and
climbing a flight of 12 steps without discomfort, exhaustion or risk of
falling. This must be done reliably, repeatedly, safely and in a timely
manner, which takes into account speed, time taken and manner of
mobilising.

a

Has no
difficulty mobilising indoors and outdoors

N/A

Occ

Freq

Most

b

Cannot climb or
descend a flight of 12 steps

c

Has some difficulty[1] mobilizing,
indoors and outdoors, for long periods[2]

d

Has significant difficulty[3] mobilising,
indoors and outdoors, for long periods

e

Has some
difficulty mobilising, indoors and outdoors, for short periods[4]

f

Has
significant difficulty mobilizing, indoors and outdoors, for short
periods

2.Getting About

Getting to familiar and unfamiliar
places reliably, repeatedly, safely and in a timely manner, unaided by
another person.

a

Has
no difficulty getting to familiar and unfamiliar places.

N/A

Occ

Freq

Most

b

Because
of distress or disorientation has some difficulty getting to unfamiliar
places

c

Because
of distress or disorientation has significant difficulty getting to
unfamiliar places

d

Because
of distress or disorientation has some difficulty getting to familiar places

e

Because
of distress or disorientation has significant difficulty getting to familiar
places

3.Navigating

Navigating around familiar and unfamiliar places unaided
by another person reliably,
repeatedly, safely and in a timely manner, using
a guide dog or other aid if normally used.

a

Able to navigate
around familiar and unfamiliar places

N/A

Occ

Freq

Most

b

Has
some difficulty navigating around unfamiliar surroundings, without being
accompanied by another person, due to sensory impairment

c

Has
significant difficulty navigating around unfamiliar surroundings, without
being accompanied by another person, due to sensory impairment

d

Has
some difficulty navigating around familiar surroundings, without being
accompanied by another person, due to sensory impairment

e

Has
significant difficulty navigating around familiar surroundings, without being
accompanied by another person, due to sensory impairment

Movement
– at a work station

4.Standing
and sitting

Reliably,
repeatedly, safely and in a timely manner, using any aid that it is
reasonable to expect them to use, and without receiving physical assistance
from another person:

·Staying in one
position (such as a workstation) for at least an hour, either by standing,
sitting or a combination of the two, and

·Moving between
this position and another.

a

Able to stay in one position for at
least an hour, either by standing, sitting or a combination of the two, and
able to move between this position and another

Claimant
cannot:

N/A

Occ

Freq

Most

b

Stay in one position (either by
standing, sitting, or a combination of the two) unassisted by another person
in one place for more than one hour without significant discomfort, loss of
balance or exhaustion

c

Stay in one position unassisted by
another person in one place for more than 30 minutes (either by standing,
sitting, or a combination of the two)without significant discomfort, loss of balance or exhaustion

d

Move from a seated position to a
mobilising position without physical assistance from another person

5.Reaching,
picking up and moving

Reaching
up, down or sideways a reasonable distance, and picking up and move a range
of differently-sized objects up to 1kg

Understanding communication reliably, repeatedly, safely and in a timely manner, by both verbal means (such as
hearing or lip reading), non-verbal means (such as intonation or body language)
and written means (such as reading
16 point print or Braille), using any aid it is reasonable to expect them to
use

a

Has
no difficulty understanding communication

Due to sensory, cognitive or social
difficulties:

N/A

Occ

Freq

Most

b

Has
some difficulty understanding complex information from a stranger

c

Has
significant difficulty understanding complex information from a stranger

d

Has
some difficulty understanding simple information from a stranger

e

Has
significant difficulty understanding simple information from a stranger

14. Making
self understood

Making self understood reliably, repeatedly,
safely and in a timely manner through speaking, writing, typing, or other
means normally used, unaided by another person

[1]Some
difficulty - could include has to do so at a slow pace and to stop during
the process of walking the distance on one occasion. May
have problems with balance but not at risk of falling.

[2] Long periods - can
walk for a period of 10 minutes or distance of 500m, (journey to/from work:
having to get out of a house to a bus stop or equivalent)

[3] Significant difficulty - could
include the pace would be significantly slow, movement is restricted or
painful, the person has to stop on more that one occasion, there is a
significant risk / history of falling, or is unable to mobilise independently.

[4]Short period - can walk for a period of a
minute (whatever consensus is for times) or distance of 50m (something that
represents moving around in a work place).

8 comments:

Anonymous
said...

With the Mind guest post recently, and now this, it feels very much like you are being used as a reaction tester. Anythhing of any importance seems to be being spread to the masses and reactions asked for through you and Sue.

Time is limited on making comments on the individual descriptors and there respective application; but from a glance I'm not sure if it is significantly better than what we have now particularly in respect of the mental health descriptors.

As I see it (from a welfare benefit specialists' point of view) the greatest problems with the descriptors are the way they are relayed from the ESA 50 by the claimant to the HCP on the ESA 85 to the decision-maker in the scoring process when considering the regulations contained within schedule (2). A major flaw in the whole process is the way the regulations (in whatever form they take) are 'condensed' in to the ESA 50. I would like to see much clearer explanations as to the application of the descriptors so that the claimant at least has a clue over how they are being considered.

It would be good to see a much clearer distinction between mental health and physical with perhaps a dividing page explaining the difference. There should also be a section at the beginning giving a claimant a clear explanation over examples of 'physical' and 'mental' with guidance on how to consider conditions where the two may merge.

It is the layout of the ESA 50 in itself which is very much the problem. Provision should also be made for advising the claimant to indicate how they felt at the time they felt when answering a particular descriptor (many complete a section at a time over the course of quite a few days). It would also be good to have a section which could be completed by the claimant's doctor/CPN etc in accordance with a revision on the medical evidence requirement contained within regulation 21 of the original ESA 2008 regs.

In essence what I am saying is that no matter how the descriptors are re-worded, the fundamental problem is in many cases the self assessment form used by the claimant to indicate his or her problems. It should more accurately portray what the statutory test is in a language which the claimant is able to relate to. In making it 'user friendly' there is a danger in straying too far from the regulations. It's a difficult balance I know but at the moment claimant's are just looking at the lead 'yes' or 'no' question attached to the descriptor and often indicating 'no' because they can't see how there is a relevance to them. When the regulations are applied it all takes on a different meaning.

One question which for instance I think should be included is one relating to whether the claimant needed to be helped in completing the form, it gives an indication as to their own difficulties in comprehending the meaning.

Social phobia and problems with a lack of assertiveness are inherently linked to the amount of support a claimant needs to find employment as are lack of motivation, need of encouragement, coaxing & persuasion. The form should be much more 'employment focussed' because ultimately it is about recognising the problems claimants will face in that environment. The claimant's limitations have to be considered as if they were in the workplace. Their ability to cope with pressure must be considered with regard to if they were in work?

Hope this helps and please do let me know how you get on with this Sue; great work by the way!

While the proposed descriptors are a definite improvement on the current ones, they don’t address what to me is the main issue, i.e. how much mental and physical activity a person is able to do on a given day. The descriptors assess functional abilities in isolation and therefore fail to reflect the demands of real jobs. For instance, you are asked about your ability to remain at a work station, but not whether you have enough mental and physical energy to actually do your job.

I fail to understand why any disabled people would benefit from a slight degree of understanding on how they are going to be abused - as if it would help?????

These descriptors are still underpinned by an ideology that is reminiscent of nazi warfare!! In no way, even if you can move a cardboard box, does it put anything in a context. Each individual point is purely that - individual, devoid of context, not based on realtime experience, it is a sham.

The real part disabled people have to play is in the total and utter removal of the WCA from anything to do with their lives.

I look at that list and see bugger all recognition of the effects conditions such as ASD have on physical ability. The movement at a work station descriptor, for example, assumes that physical disability is the only inhibiting factor in staying in one position for one hour.

Our oldest boy has ASD and he is completely unable to stay in one position for five minutes, let alone an hour. He doesn’t suffer significant discomfort, loss of balance or exhaustion because the problem isn’t physical. It’s mental. He can not stay still, fidgets, roams, bounces, rocks and bumps.

And the descriptors don’t allow for complex behaviours. Look at the learning tasks descriptors, it’s A, B, C or D but there’s no allowance for someone who can learn extremely complex tasks while struggling with simple every day ones. Our oldest can disassemble and reassemble a computer in the blink of an eye, but can’t clean his teeth, wash effectively or dress without supervision. So one assessor might rate him A and another D.

Or the continence one. He has no problem with control. What he has a problem with is understanding that it’s anti-social to walk to the back door and piss out of it because he can’t be bothered waiting for someone else to finish in the bathroom.

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